Individual ProviderCamilla CarrSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7100PECOS EnrollmentBased on the most recent information from CMS, provider Camilla Carr does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1164860094Provider TypeIndividualFull NameCarr, CamillaCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date6/13/2013Last Updated9/25/2014Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7100FaxUnlisted FaxMailing LocationMailing Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense80175193501UtahCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer